What is prolotherapy?
Prolotherapy is a regenerative treatment involving the injection of a mild irritant solution into damaged joints, ligaments, and tendons. The solutions initiates the body’s natural healing mechanism by inducing the local in flammatory response necessary to activate the immune system to initiate tissue repair. Because pain is an indication of tissue damage, the pain can be eliminated as the tissue heals after the Prolotherapy treatment series.
The term “Prolotherapy” was first used by George Hackett, MD, and named from the word “proliferate”, which means to rapidly grow new cells. These newly created cells can cause hard-to-heal areas, such as ligaments, tendons, and cartilage to repair, strengthen and tighten over time, restoring a painful, unstable joint, into a stable and healthy one.
What conditions does it help?
- Damaged, sprained, torn ligaments and tendons.
- Pain when the joint is first used that is relieved after repeated movement.
- Trigger points or knotted muscles that keep recurring in the same locations or that don’t respond to other treatment. Recurring trigger points may indicate that there is a problem elsewhere in the body that is affecting the muscle(s).
- Arthritic joints by stabilizing the joint capsule and surrounding ligaments.
What substances are used in the injection?
Prolotherapy solutions contain anesthetic agents and natural substances. The most commonly used is a mixture of dextrose (sugar water), Vitamin B12, and lidocaine.
What happens after the prolotherapy procedure?
Prolotherapy will initiate productive inflammation and may cause the body part treated to be sore for up to a week. Anti-inflammatory drugs (i.e. ibuprofen, Naprosyn, Celebrex) and corticosteroids such as prednisone can blunt or stop this process, so it is important to not take any anti-inflammatory drugs for 5 days prior to treatment and for at least three weeks after completion of prolotherapy. Tobacco should be avoided as it is a potent toxin and its use constricts small blood vessels, which are needed for tissue repair.
What are the side effects?
Injection side effects, such as soreness at the area of injection, are common.
Infection is always a risk with any type of injection; however, the risk is less than the risks associated with much more commonly performed corticosteroid injections.
How long does it take to see results?
While some patients will have an excellent response in the first 2-3 weeks, in many cases, patients may not feel pain relief after their first or second treatment. This does not mean that the treatment is not working. Rather, it is an indication that the ligaments and tendons are not yet strong enough to stabilize the joints. The amount of collagen growth required to stabilize the joint is different for each person. If absolutely no improvement is seen after the third injection series, we will discontinue prolotherapy, as it is unlikely to help.
How often are treatments given?
While response to treatment varies, most people will require at least three to four injections, about 2 weeks apart. There is no limitation to the number of treatments a person can get. The total number of treatments will depend on the condition and response.
A minimum of three sessions usually is required to see clinical improvement, although some patients experience relief after one injection.
Treatments are usually stopped if:
- You are markedly better (at least 80-90% improved).
- You are satisfied with your improvement and simply wish to stop treatment.
- There is no further improvement (you have reached a “plateau”).
